Don’t be misled and fooled by “herniated discs pressing on nerves”!

At present, most doctors and patients believe that “it is the herniated intervertebral disc that presses on the nerves and produces low back pain in patients, and the larger the herniated intervertebral disc, the more serious the low back pain”. In the absence of CT and MR imaging, doctors and patients were convinced of this statement, and even more so when CT and MR imaging were available. Therefore, doctors and patients tried every possible means to make the herniated intervertebral discs disappear or shrink back through various treatments in order to eliminate the clinical symptoms of the patients. Before CT-guided drug intervention, we also followed this theory to guide our work. However, in nearly two decades of clinical practice, we have found that there is a discrepancy between the facts and the theory. Due to the advantages and special characteristics of our work as radiologists, we receive dozens of patients who come for lumbar spine CT or MR examination because of low back pain every day, and our research on the correlation between lumbar disc herniation and clinical symptoms of low back pain has found that: 1) patients with disc herniation and clinical symptoms of low back pain on preoperative CT or MR examination, and even though their clinical symptoms of low back pain disappeared, their clinical symptoms on postoperative imaging were not as clear as before. After surgery, although the clinical symptoms of low back and leg pain disappeared, the postoperative imaging was the same, and the herniated disc was still herniated and had not disappeared because of the surgery. 2, some patients in the imaging examination is bulging, although he did not see the protruding disc compression of the nerve, but can have and herniated disc and the same clinical symptoms of low back and leg pain, 3, we carried out CT-guided drug intervention since 1993, many of the majority of doctors believe that must be surgical treatment of intervertebral disc herniation patients (including the disc of the severe herniation or with free disc) through the intervention, the patient’s clinical back and leg pain, the patient’s clinical symptoms of back and leg pain. After the interventional treatment, the clinical symptoms of low back and leg pain disappeared, but the intervertebral disc was still found to exist in the imaging examination. 4. Some patients’ CT and MR imaging examinations showed that the herniated discs did not match their clinical symptoms; for example, the discs were herniated on the left side, but the radiating pain of the lower extremities was on the right side; or some patients had herniated discs in the L5-S1 region, but their clinical symptoms were caused by the lesions of the L4-5 discs. Therefore, clinical practice tells us: 1, clinical symptoms of low back pain in patients, imaging (CT, MR) can be disc herniation! 2, Imaging examination (CT,MR) have disc herniation, clinical can have no low back pain symptoms! 3, Imaging tests (CT,MR) have a herniated disc. Patients with no clinical symptoms of low back and leg pain should not worry about the herniated disc and do not need any treatment!!!!